Date of request:* 7/24/2024 7:14:58 PM Please allow at least two weeks to receive requested data. Processing time may take longer during peak reporting periods.
Expected Date of completion:*8/7/2024 7:14:58 PM

First Name:*

Last Name:*

Email Address:*


Phone Number:*

Division / School:*


Please indicate if you are:*
Are you requesting this information on the behalf of someone else?*  

 (intended use is to complete a survey)  
  (intended use is to create a survey)

Purpose of Data Request*


Please identify desired population and/or data selection criteria (i.e. all first-time Freshman, students with GPA > 3.0, etc)*


Reporting Period for this Request: (check all that apply)*

From:                                                To:


Do you have Internal Review Board (IRB) approval? If “Yes”, please attach a PDF copy of IRB approval letter.

Additional Supporting Documents? Do you have additional information demonstrating your proposed data project need?

Upload:(upload forms, max 10 documents only PDF Files )

I understand my obligation to treat, protect and dispose of any data I receive in accordance with JSU's policy on confidential and sensitive data and the College's record retention policy.  For student educational records, I also understand my obligations under FERPA.